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General NPI Number Information
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NPI Number | 1760449623
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Entity Type | Organization
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Legal Business Name | SINCLAIR & CAMP, OD, PA
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 615 S ORANGE AVE
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City | SARASOTA
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State | FL
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Zip | 34236-7503
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Country | US
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Telephone | 941-366-2892
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Fax | 941-366-2893
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Provider Business Mailing Address
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Address Line | 615 S ORANGE AVE
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City | SARASOTA
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State | FL
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Zip | 34236-7503
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Country | US
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Telephone | 941-366-2892
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Fax | 941-366-2893
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. LORI CAMP
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Credential | OD
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Telephone | 941-366-2892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OP02495
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OP02495
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP02495
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License Number State | FL
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